Telaprevir, Incivek, Sovaldi, Olysio & sex

The new hepatitis C treatment drug telaprevir -- also known as Incivek -- further complicates the issue of sex during hepatitis c treatments.

While sex certainly is possible for many telaprevir patients over the three-month treatment period, there are considerations and concerns.

Telaprevir's unpleasant side effects almost certainly will impact patients' sex lives. The drug, however, does not list a lack of sexual desire or male sexual disfunction among its side effects, nor do there appear to be widespread reports of performance problems.

Update: This also is true of the antiviral Sovaldi (sofosbuvir), the pill approved by the FDA in December 2013. Its side effects that likely would affect sex lives include fatigue, headache, nausea, insomnia and diarrhea. For Olysio, also recently FDA-approved, side effects include nausea and rashes.

Telaprevir/Incivek is one of two antiviral drugs approved by the FDA in May 2011 for hepatitis c treatment. Like boceprevir (Victrelis), it is a "protease inhibitor" that attacks the virus' ability to replicate. There are no known studies specific to the sexual side effects of taking these drugs.

Telaprevir's No. 1 safety warning directly applies: "If you or your sexual partner is pregnant or plan to become pregnant, do not take these medicines. You or your partner should not become pregnant while taking Incivek with peginterferon alfa and ribavirin and for 6 months after treatment is over."

The "serious side effects of telaprevir" include "birth defects or death of an unborn baby." (These warnings apply for peginterferon alfa and ribavirin as well.)

The telaprevir manufacturer safety information directs patients and their partners to use "two effective methods" of birth control that do not contain hormones. The warning period extends beyond the medication period. (Read the telaprevir warnings about pregnancy and sex.)

For patients who undergo the 12-week telaprevir/Inciver treatment with or without the possibility of pregnancy, there are other side effects that could derail sexual activity.

These side effects include:

Anal itching and burning. Widely reported by people who take telaprevir. These side effects include "hemorrhoids, discomfort or burning around or near the anus, itching around or near the anus." Patients often are advised to use diaper treatments such as Desitin for relief of these symptoms.

Skin rashes. Reactions on the skin range from mild to severe enough to require hospitalization. Can cover large parts of body.

Mouth sores. Could make oral sex difficult or impossible.

And of course the fatigue, nausea, amenia, flu-like feelings and shortness of breath long associated with the standard interferon/ribavirin regimen.

Another possible barrier to sexual activity during treatment with telaprevir is the consumption of fat (20 grams) required three times a day when taking the two "horse" pills. For example, a large serving of ice cream or bagel with a generous application of cream cheese. Many patients gain weight and feel bloated throughout the day as a result. "I'm sick of eating -- my stomach feels full, bloated, swollen, or inflamed 24-7 and still have to eat all that fat," one patient reported on a triple-therapy forum.

Some doctors may order or advise sexual abstinence during treatment that includes Incivek.